DONG WOOK KIM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

CANCELLED

Business

Title

First Name

DONG WOOK

Last Name

KIM

Business Name

DONG WOOK KIM MD

Original Issue Date

04/17/2008

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011